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NOTE: EASIEST IS TO COPY AND PASTE THIS INTO A WORD DOCUMENT, RATHER THAN PRINTING STRAIGHT FROM THIS PAGE, DUE TO FORMATTING ISSUES. LEASE TERM DESIRED:______________ Hartog&Hall MOVE-IN DATE DESIRED:______________Rentals
APPLICATION TO RENT TENANT'S PERSONAL AND CREDIT INFORMATION MUST BE FILLED OUT COMPLETELY TO BE PROCESSED (Please write “N/A” rather than leaving a line blank) PERSONAL DATA :NAME ____________________________________ BIRTHDATE_______________ SS# ____________________DRIVERS LIC.# _________________________ STATE ISSUED: _____________________ CURRENT PHONE# _____________ NAME OF CO-TENANTS _______________________________________________________________________________MAIDEN NAME OR ALIAS/ IF DIVORCED, PREVIOUS NAME ___________________________________________________PRESENT ADDRESS ________________________________________________________________ZIP__________HOW LONG AT PRESENT ADDRESS ________ REASON FOR MOVING________________________CURRENT RENT: $_______CURRENT LANDLORD NAME __________________________________________________PHONE#_____________________PREVIOUS ADDRESS ________________________________________________ZIP_________ PREVIOUS RENT:$________PREVIOUS LANDLORD NAME ________________________________PREVIOUS LANDLORD PHONE#_______________________NUMBER OF OCCUPANTS _______ RELATIONSHIPS TO SELF_________________________________________________ AGES________________________________________________ NUMBER OF OCCUPANTS WHO SMOKE_________LIST ANY PETS___________________________________________________________________NUMBER OF VEHICLES__________________ CAR MAKE___________________________ YEAR________ MODEL______________________ COLOR_________LIC.PLATE#_______________ CAR MAKE_ _____________________ YEAR________ MODEL______________________ COLOR_________LIC.PLATE#________________________________________________________________________________________ OCCUPATION : 1) PRESENT OCCUPATION 2) PRIOR OCCUPATION______________________________________________________________________________________________________________________ EMPLOYER ______________________________________________________________________________________________________________________ SELF-EMPLOYED, D.B.A. ______________________________________________________________________________________________________________________ BUSINESS ADDRESS _______________________________________________________________________________________________________________________ PHONE ______________________________________________________________________________________________________________________ POSITION HELD ______________________________________________________________________________________________________________________ HOW LONG ______________________________________________________________________________________________________________________ NAME AND TITLE OF SUPERIOR ______________________________________________________________________________________________________________________ TYPE OF BUSINESS _____________________________________________________________________________________________________________________ MONTHLY GROSS INCOME ____________________________________________________________________ ___________REFERENCES PLEASE LIST ANY LOCAL REFERENCES Name Phone # Relationship to self _______________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ ______________________________________________
ADDRESS OF PREMISES OFFERED FOR RENT_____________ 503 Lauloa St., Kihei, HI 96753_______________I UNDERSTAND AND AGREE THAT SECURITY AND 1ST MONTH’S RENT MUST BE POSTED PRIOR TO THE EXECUTION OF A LEASE AGREEMENT IN CERTIFIED FUNDS, MONEY ORDER OR CASH. RENTAL PRICE:_$__ 1,250.00___SECURITY:__$____2,250.00______ (does not include electric)
**************************************Fill This section out in presence of rental agent (landlord):****************************************************** I HEREBY DEPOSIT THE SUM OF _________ WITH THE LANDLORD/AGENT TO SECURE THE ABOVE PREMISES TO RENT, PENDING EXECUTION OF A LEASE AGREEMENT. I UNDERSTAND THAT MY DEPOSIT MAY BE APPLIED TOWARD ANY RENT LOSS OR OTHER EXPENSES THE LANDLORD/AGENT MAY INCUR AS A RESULT OF MY FAILURE TO FULFILL MY PROMISE TO RENT THE ABOVE NAMED PREMISES BY SIGNING A LEASE AGREEMENT NO LATER THAN _________TO OCCUPY BY ________. LEASE TERM:________.***************************************************************************************************************************************************************************** LANDLORD/AGENT AGREES THAT THE DEPOSIT IS REFUNDABLE IF THE ABOVE APPLICANT IS NOT APPROVED, PROVIDING THAT THIS APPLICATION HAS BEEN FILLED OUT COMPLETELY AND TRUTHFULLY. HAVE YOU OWNED A HOME IN THE PAST? _______. IF YES, HOW LONG? ________. HOW MANY? __________. HAVE YOU EVER FILED A PETITION FOR BANKRUPTCY?___________________ IF YES, WHEN?______________. HAVE YOU EVER BEEN EVICTED FROM ANY TENANCY? ___________________. HAVE YOU EVER WILLFULLY AND INTENTIONALLY REFUSED TO PAY RENT WHEN DUE?___________________.
I HEREBY AUTHORIZE LANDLORD/AGENT TO VERIFY THE VALIDITY OF ALL THE ABOVE INFORMATION, AND TO INQUIRE WITH MY EMPLOYERS, FINANCIAL INSTITUTIONS, AND ANY OF THE CREDIT REPORTING BUREAUS AVAILABLE TO HIM. I AGREE TO SUPPLY ANY ADDITIONAL INFORMATION NEEDED BY OWNER/AGENT TO PROCESS THIS APPLICATION AND I ACKNOWLEDGE THAT MY DEPOSIT WILL BE FORFEIT IF I DO NOT COMPLY WITH ANY SUCH REQUEST. I AGREE THAT MY SCREENING FEE OF $15.00 per adult applicant_____ IS NON-REFUNDABLE. I HEREBY ACKNOWLEDGE RECEIPT OF A COPY OF THIS APPLICATION AGREEMENT. I AGREE THAT LANDLORD MAY TERMINATE ANY AGREEMENT ENTERED INTO IN RELIANCE ON ANY MISSTATEMENT MADE ABOVE. I DECLARE, UNDER PENALTY OF PERJURY, ALL OF THE ABOVE INFORMATION TO BE TRUE AND CORRECT, TO THE BEST OF MY KNOWLEDGE.
APPLICANT_______________________________________________ DATE_________________________
ATTENTION RENTAL AGENTS: SECURE YOUR TRANSACTION! Before submitting, be sure you have:1. Full required deposit in cash or money order made out to “Hartog & Hall Rentals.” (If wanting to hold place in line) 2. Application completed in full 3. Copy of government-issued identification
PLEASE CALL (808)269-2899 TO DROP OFF COMPLETED APPLICATION, COPY OF ID & APPLICATION FEE Raven & Timothy Hartog-Hall PO Box 2066, Kihei, HI, 96753 Phone: (808)269-2899 Fax: (888)501-5657 rent@rentmemaui.com |